Meningococcemia cost-effectiveness of therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]

Cost effective analysis study has indicated that a 2-dose series at ages 11 years and 16 years has a similar cost-effectiveness compared with moving the single dose to age 15 years or maintaining the single dose at 11 years.

• As part of the evaluation of the adolescent vaccination program, a cost-effectiveness analysis was performed to compare the cost-effectiveness of the following three vaccination strategies: ^[1]

• A single dose at age 11 years
• A single dose at age 15 years
• A dose at age 11 years with a booster dose at age 16 years. The economic costs and benefits of these meningococcal vaccination strategies in adolescents were assessed from a societal perspective ^[2][3].

• A multivariable analysis was performed with a Monte Carlo simulation in which multiple parameters were varied simultaneously over specified probability distributions.
• These parameters included disease incidence (46%–120% of the 10-year average), case-fatality ratio (34%–131% of the 10-year average), rates of long-term sequelae, acute meningococcal disease costs (i.e., inpatient care, parents’ work loss, public health response, and premature mortality costs), lifetime direct and indirect costs of meningococcal disease sequelae (i.e., long-term special education and reduced productivity), and cost of vaccine and vaccine administration (range: $64–$114).
• Vaccination coverage (37%–90%) and initial vaccine efficacy (39%–99%) also were varied for evaluation purposes.
• The vaccine was assumed to be 93% effective in the first year, and then waning immunity was modeled as a linear decline over the next 9 years unless a booster dose was administered.
• The vaccine effectiveness of the second dose was assumed to be higher with a slower rate of waning immunity.
• The results of the cost-effectiveness analysis indicate that a 2-dose series at ages 11 years and 16 years has a similar cost-effectiveness compared with moving the single dose to age 15 years or maintaining the single dose at 11 years. However, the number of cases and deaths prevented is substantially higher with the 2-dose strategy